Peer Reviewed
ECG education
A 76-year-old man with ventricular tachycardia
Abstract
James is 76 years old and exercises regularly. He has noted some irregularity and rapidity of his pulse rate directly after exercise on two occasions and felt weak and unwell at that time. He had no chest pain. You arrange a 24-hour Holter monitor and an ECG. Both show the same rhythm (see Figure of ECG result below).
Key Points
- Ventricular tachycardia (VT) is three or more heart beats with a rate over 100 beats per minute. The QRS is widened over 120 msec and there is atrioventricular dissociation.
- Any arrhythmia occurring during exercise should be taken seriously and fully investigated as exercise is a known trigger of VT.
- An implantable catheter defibrillator is usually first-line management for VT.
- Medications (beta blockers, sotalol, amiodarone and rarely flecainide) may be used in conjunction with implantable cardioverter defibrillators to reduce the number of defibrillations occurring.
- Ablation is considered if VT is refractory or highly recurrent and not adequately controlled by medications.
Purchase the PDF version of this article
Already a subscriber? Login here.